Failures of Realignment Osteotomy

Schubert, Manuel F.; Sidhu, Roger; Getgood, Alan; Sherman, Seth L.

doi:10.1016/j.otsm.2019.150714

Cited by 3 publications

(1 citation statement)

References 117 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Except for external fixation methods, maintenance of the PTO correction is traditionally completed with a metal plate. These plates have been shown to have drawbacks, especially hardware irritation by pressing on nearby structures, including the pes anserinus and hamstring tendons, the medial collateral ligament, and the overlying subcutaneous tissue and skin, necessitating subsequent plate removal [59].…”

Section: Post‐operative Complicationsmentioning

confidence: 99%

A systematic approach to managing complications after proximal tibial osteotomies of the knee

Valcarenghi,

Vittone,

Mouton

et al. 2023

J. exp. orthop.

View full text Add to dashboard Cite

Proximal tibial osteotomy (PTO) is an effective procedure for active and young adult patients with symptomatic unicompartmental osteoarthritis and malalignment. They were considered technically demanding and prone to various complications related to the surgical technique, biomechanical or biological origin. Among the most important are hinge fractures and delayed or non-healing, neurovascular complications, loss of correction, implant-related problems, patellofemoral complaints, biological complications and changes in limb length. Being aware of these problems can help minimizing their prevalence and improve the results of the procedure.The aim of this narrative review is to discuss the potential complications that may occur during and after proximal tibial osteotomies, their origin and ways to prevent them.

show abstract

Section: Post‐operative Complicationsmentioning

confidence: 99%

A systematic approach to managing complications after proximal tibial osteotomies of the knee

Valcarenghi,

Vittone,

Mouton

et al. 2023

J. exp. orthop.

View full text Add to dashboard Cite

show abstract

Larger lateral hinges increase the probability of Takeuchi type II and III fractures in high tibial osteotomy

Saghaei,

Salehipour,

Hashemi

2024

Eur J Orthop Surg Traumatol

View full text Add to dashboard Cite

Finite Element Analysis of Protective Measures against Lateral Hinge Fractures in High‐Tibial Osteotomy

Özmen,

Baris,

Circi

et al. 2024

Advances in Orthopedics

View full text Add to dashboard Cite

Background. Opening wedge high‐tibial osteotomy (OWHTO) is widely used for correcting mechanical axis deviations and offloading the medial compartment in unicompartmental osteoarthritis. However, lateral hinge fractures (LHFs) pose a significant complication. This study investigates protective measures to mitigate these fractures, guided by prior observations of mechanical stress impact on LHFs. Purpose. The study aims to assess the effectiveness of different protective measures, specifically the use of varying sizes of Kirchner wires and drill holes, in reducing the incidence of LHFs during OWHTO. Study Design. The study employs a quantitative, comparative analysis using a finite element method (FEM) based on computed tomography (CT) scans. Methods. Using CT‐based FEM, the study compares the impact of different sizes of K‐wires (1.6 mm, 2.0 mm, and 2.5 mm) and drill holes (3.2 mm and 4.5 mm) on the mechanical stresses around the hinge area in OWHTO. The models were created from a CT scan of a healthy 33‐year‐old male, focusing on the force required to open the osteotomy gap and the incidence of cracked shell elements. Results. The study found that thicker K‐wires increased the force required to open the osteotomy gap, whereas larger apical holes decreased it. The 4.5 mm apical hole model demonstrated significantly fewer cracks compared to the 2.0 mm K‐wire model, with no significant difference observed compared to the 2.5 mm K‐wire model. Models using a 1.6 mm K‐wire or a 3.2 mm drill hole did not significantly reduce cracks compared to the base model. Conclusions. The findings suggest that a 4.5 mm drill hole may be more effective in reducing the risk of LHFs compared to thinner diameter K‐wires or smaller apical holes. Both a 2.5 mm K‐wire and a 4.5 mm drill hole reduce the number of cracked elements, but the 4.5 mm drill hole also significantly decreases the average and maximum principal stresses as well as the average tensile strength ratio at the hinge area. These findings may be important for surgical planning, particularly in cases requiring increased osteotomy distraction.

show abstract

Failures of Realignment Osteotomy

Cited by 3 publications

References 117 publications

A systematic approach to managing complications after proximal tibial osteotomies of the knee

A systematic approach to managing complications after proximal tibial osteotomies of the knee

Larger lateral hinges increase the probability of Takeuchi type II and III fractures in high tibial osteotomy

Finite Element Analysis of Protective Measures against Lateral Hinge Fractures in High‐Tibial Osteotomy

Contact Info

Product

Resources

About